Respiratory viral infections are a significant cause of morbidity in asthma (1). Patients with severe asthma were assumed to be at greater risk from novel coronavirus-2 (COVID-19) infection. In the global response to the COVID-19 pandemic, multiple countries enacted social containment policies.

We read with interest the paper by LEE et al. [1], reporting on the high rate of nonadherence in a group of severe asthma patients who were potentially suitable for biological therapy or bronchial thermoplasty. In our experience the issue of nonadherence is not confined to patients under active consideration for biological therapy. We have identified significant rates of nonadherence in a group of patients on long-term Omalizumab therapy.

People with severe and difficult to control asthma can be a complex and heterogenous group of patients often with multiple comorbidities. Living with this disease imposes a huge physical and psychological burden upon the patient which requires a comprehensive, systematic and patient-focused assessment, using a wide range of clinical expertise from within the multidisciplinary team. This article describes a severe asthma systematic and multidimensional day case assessment, and the positive benefits that the authors perceive it offers for patient care. These benefits include a confirmed diagnosis, consideration of alternative diagnosis, enhanced adherence, medication optimisation, access to and gatekeeping of high-cost specialist medications, improved patient self-management skills and signposting to appropriate therapies. As a consequence, they believe that this facilitates better patient outcomes through a reduction in corticosteroid exposure, exacerbations and hospitalisation. This severe asthma multidisciplinary team day case approach offers more than just physical benefits when compared with the traditional medical model. Patient feedback reports an excellent patient experience, feeling listened to, understood, empowered and hopeful for the future.